Durlston House

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The provider had shared their values statement with people, setting out what they should expect from the service. Staff told us the management team demonstrated the provider’s values in the way they worked. The values and how they were applied was discussed in staff meetings and staff appraisals.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The service had a manager who was registered with the Care Quality Commission, although they were on a period of extended leave at the time of the inspection. The service was being managed by the deputy manager and the registered manager of one of the provider’s other services. Staff told us the management team were knowledgeable and provided them with the support they needed to do their job well. Staff felt the arrangements to cover the registered manager’s absence were working well. Comments from staff included, “[The covering manager] seems very good and [the deputy manager] has been great. I’m able to have discussions with them whenever I need to. They are knowledgeable and explain their decisions.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

The service had speaking up procedures which staff were able to access if they needed. Details were shared with staff during their induction, staff meetings and supervision sessions. Staff told us they knew how to raise any concerns and were confident managers would listen to them and respond. Comments from staff included, “I feel we are listened to. I would raise any issues if I needed to and feel confident [managers] would act on them.”

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider had processes for staff to request flexibility in their work patterns, for example to enable staff with caring responsibilities or those with health conditions to remain working. Staff were aware of these processes and told us they felt supported by the management team. The manager told us they tried to accommodate staff requests wherever possible.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

At the last inspection we found governance systems were not always effective at identifying areas for improvement. At this inspection this had improved. The management team completed a range of audits, surveys and observations of staff practice to monitor the quality of the service. In addition to the checks staff were completing, the provider had a quality team who completed regular quality assessments of the service. These included feedback from people and their relatives, observations of staff practice, and a review of records completed by staff. Actions from the audits were assigned to named staff with a timescale for completion. All senior managers in the organisation were able to review these actions to ensure they were completed. These systems demonstrated shortfalls were identified and actions were taken to make improvements where needed.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

Managers told us they worked in close collaboration with a range of professionals to help make sure people received continuity in their care. Examples included working with a dentist to support a person who had historically found accessing dental care very difficult, work with the medical team to reduce people’s medicines, and working with the local authority behavioural team to support a person in accessing the community safely. This work was reflected in people’s support plans.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

Systems for monitoring standards of support people received were used to identify areas of improvement and ensure lessons were learned when needed. This included regular audits and quality assurance checks. The manager said the provider had support systems which enabled managers to share experiences and learn from each other. The manager told us the service had focused on improving the quality of life for people by reducing restrictions wherever possible.